2. A 50-year-old man presents to the emergency department and is diagnosed with an acute exacerbation of COPD. The patient has a history of diabetes mellitus, chronic kidney disease, and frequent COPD exacerbations. On examination, his vital signs are as follows: blood pressure, 150/90 mm Hg; respiratory rate, 24 breaths/min; temperature, 97.6°F; heart rate, 96 bpm; oxygen saturation, 94% on 2 L/min via nasal cannula, 88% on room air. What is the next best step in managing his COPD exacerbation appropriately?

Admit to hospital

Admit to intensive care unit

Immediate intubation

Manage as outpatient

More information is required prior to making a decision regarding appropriate triaging of this patient

3. A 60-year-old woman with a 40-pack-year history of smoking is admitted to the hospital due to a COPD exacerbation. Which of the following treatments will lead to prevention of further exacerbations?

4. The patient is started on intravenous steroids, antibiotics, and frequent nebulizer treatments. Analysis of arterial blood gas (ABG) several hours following the initiation of treatment reveals worsening hypercapnia and respiratory acidosis compared with the ABG drawn in the emergency department. What is the next best step in managing this patients hypercapnia and acidosis?

If you do not already have Acrobat Reader, simply click on the icon below, scroll down to the "Get the Free Acrobat Reader" heading and follow the instructions to install the program. Acrobat enables you to convert any document into an Adobe Portable Document Format (PDF) file for easy viewing.